Hiding in Plain Sight? It’s Time to Investigate Other Possible Transmission Routes for Hepatitis E Virus (HEV) in Developed Countries

Historically in developed countries, reported hepatitis E cases were typically travellers returning from countries where hepatitis E virus (HEV) is endemic, but now there are increasing numbers of non-travel-related (“autochthonous”) cases being reported. Data for HEV in New Zealand remain limited and the transmission routes unproven. We critically reviewed the scientific evidence supporting HEV transmission routes in other developed countries to inform how people in New Zealand may be exposed to this virus. A substantial body of indirect evidence shows domesticated pigs are a source of zoonotic human HEV infection, but there is an information bias towards this established reservoir. The increasing range of animals in which HEV has been detected makes it important to consider other possible animal reservoirs of HEV genotypes that can or could infect humans. Foodborne transmission of HEV from swine and deer products has been proven, and a large body of indirect evidence (e.g. food surveys, epidemiological studies and phylogenetic analyses) support pig products as vehicles of HEV infection. Scarce data from other foods suggest we are neglecting other potential sources of foodborne HEV infection. Moreover, other transmission routes are scarcely investigated in developed countries; the role of infected food handlers, person-to-person transmission via the faecal–oral route, and waterborne transmission from recreational contact or drinking untreated or inadequately treated water. People have become symptomatic after receiving transfusions of HEV-contaminated blood, but it is unclear how important this is in the overall hepatitis E disease burden. There is need for broader research efforts to support establishing risk-based controls.     

Mercury in the Mediterranean. Part 2: processes and mass balance

Mass balance of contaminants can provide useful information on the processes that influence their concentrations in various environmental compartments. The most important sources, sinks and the equilibrium or non-equilibrium state of the contaminant in individual environmental compartments can also be identified. Using the latest mercury speciation data, the results of numerical models and the results of recent studies on mercury transport and transformation processes in the marine environment, we have re-evaluated the total mercury (HgT) mass balance in the Mediterranean Sea. New calculations have been performed employing three distinct marine layers: the surface layer, the thermocline and the deep sea. New transport mechanisms, deep water formation and density-driven sinking and upwelling, were included in the mass balance calculations. The most recent data have even enabled the calculation of an approximate methylmercury (MeHg) mass balance. HgT is well balanced in the entire Mediterranean, and the discrepancies between inputs and outputs in individual layers do not exceed 20 %. The MeHg balance shows larger discrepancies between gains and losses due to measurement uncertainties and gaps in our knowledge of Hg species transformation processes. Nonetheless, the main sources and sinks of HgT (deposition and evasion) and MeHg (fluxes from sediment, outflow through the Gibraltar Strait) are in accordance with previous studies on mercury in the Mediterranean Basin. Mercury in the Mediterranean fish harvest is the second largest MeHg sink; about 300 kg of this toxic substance is consumed annually with sea food.     

Transformation of a non-oestrogenic steroid metabolite to an oestrogenically active substance by minimal bacterial activity

The majority of oestrogenic material excreted from humans and wildlife, and therefore released into sewers, is in a conjugated form. However, the finding of “free” oestrogens in sewage effluent suggests that these metabolites are somehow converted back into an active form, before or during passage through a sewage treatment process. When male fathead minnows (Pimephales promelas) were continuously exposed to oestradiol-3-glucuronide, in a continuous-flow system, it demonstrated no inherent oestrogenic activity. However, when fish were exposed to effluent generated from laboratory simulations of sewage treatment processes, to which had been added oestradiol-3-glucuronide, oestrogenic activity was observed, suggesting microbial activity was capable of degrading the steroid metabolite into a more potent oestrogen. Oestrogenic potency was determined by measuring changes in plasma vitellogenin (egg yolk precursor) concentrations and gonadosomatic index. The results suggest that inactive metabolites of steroids are very readily biotransformed into biologically active oestrogens.     

Cancer incidence in people with residential exposure to a municipal waste incinerator: An ecological study in Modena (Italy), 1991–2005

We conducted a retrospective ecological study to assess cancer incidence during the period 1991–2005 in proximity of a municipal waste incinerator (MWI) in Modena (Italy). We identified three bands of increasing distance from the MWI, up to a radius of 5 km and used the residence as surrogate marker of the exposure. Residential history for Modena’s population was reconstructed and residents were associated to the most appropriate census unit. Age-standardized incidence ratios (ASR) and standardized incidence ratios (SIR) were estimated for all cancers and selected sites. Variations in cancer incidence were investigated using space and space–time scan statistic. Deprivation index was taken into account as potential confounding factor. During the 15-year study period, 16,443 new cases of cancer were diagnosed among residents in Modena. The space–time clustering test identified three significant clusters but their shapes were not associable to the MWI exposition. The purely spatial analysis not showed statistically significant clusters. The SIR computed for all cancers and selected sites did not show any excess of risk in the area closest to the plant. Higher SIR for leukaemia was found in the second band from MWI (2–3.5 km) for females (SIR, age and DI adjusted: 1.35, 95%CI: 1.01–1.79) and for both sexes (SIR, age and DI adjusted: 1.28, 95%CI: 1.03–1.57), but not a spatial trend was observed, thus excluding a possible link with MWI. In conclusion, bearing in mind the intrinsic limits of the study, the results suggest that there is no detectable increase of cancer risk for people living in proximity to the Modena MWI.     

Endocrine disruptors compounds, pharmaceuticals and personal care products in urban wastewater: implications for agricultural reuse and their removal by adsorption process

In the last years, a lot of emerging contaminants, such as, endocrine disruptors compounds (EDCs), pharmaceuticals, and personal care products (PPCPs) have been detected in wastewater. Because of their toxicity and possible adverse effects on the environment and humans, their release from urban wastewater treatment plants (UWWTPs) effluents should be minimized, particularly when a wastewater reuse for crops irrigation is expected. Many processes have been investigated for advanced treatment of UWWTP effluents as well as for emerging contaminant degradation; among these, adsorption process was successfully used to remove EDCs and PPCPs from wastewater. This article shortly reviews EDCs and PPCPs removal from UWWTP effluents by adsorption process using conventional and non-conventional adsorbents. The fate of EDCs and PPCPs in UWWTPs and the implications for agricultural wastewater reuse has been addressed too. In spite of the adsorption process looking to be a valuable alternative to other advanced technologies for the removal of emerging contaminants from wastewater, some gaps still remain to evaluate the actual feasibility at full scale. However, according to a few studies available in scientific literature on the use of both powdered activated carbon and granular activated carbon at full scale, adsorption process by activated carbon is a promising, potentially effective, and economically feasible solution for producing safe wastewater for agricultural reuse.